Minimally invasive surgical procedures are becoming more common as surgeons use a variety of techniques to operate with reduced trauma to the body than with open surgeries. In general, minimally invasive surgical procedures are safer than open surgeries and allow the patient to recover faster and heal with less pain and scarring. Minimally invasive surgical procedures are typically performed with one or more incisions to the body where surgical instruments are inserted and maneuvered into the surgical site to treat the targeted tissue.
A polyp is an abnormal growth of tissue projecting from a base region of tissue, typically that includes a mucous membrane. Polyps can be attached to the surface of the mucous membrane by a narrow elongated stalk, in which case the polyp is said to be pedunculated. If the polyp is directly attached to the base region of tissue with no stalk, the polyp is said to be sessile. Polyps can be found in various regions within the body such as the colon, stomach, nose, urinary bladder, cervix, small intestines, and uterus.
Polypectomy performed via an endoscopic or laparoscopic procedure performed through the oral or anal cavities are much more preferred over open procedures. Polyps are conventionally removed using either electrical forceps or an electrosurgical wire loop that is positioned around the base of the stalk of the polyp where the device severs the polyp (or stalk) as well as coagulates the blood vessels in the stalk of the polyp. However, in any procedure using conventional devices, especially those performed minimally invasively, the physician must take care to remove the polyp or stalk while remaining safely spaced away from the base region of tissue. Otherwise, inadvertent removal of the base tissue can create additional trauma via an opening in the base tissue. For example, unintentionally creating an opening in an organ, including but not limited to, the colon, stomach, nasal cavity, urinary bladder, cervix, small intestines, or uterus can require immediate surgery to repair the opening. Moreover, repairing any opening created as a result of removal of suspect tissue can require complicated or time consuming stitching or suturing to close the opening in the base tissue of the organ. There is also a risk of post-surgical complications if the physician does not properly close the opening.
Many times polyps or other suspect regions of tissue are identified during examination procedure as opposed to a surgical procedure. The risks associated with inadvertently creating an opening in an organ during removal of suspect tissue can present a dilemma for a physician that first observes the polyp (or other suspect tissue) but is hesitant to remove it if the physician believes that it will be difficult to maintain a clean margin (i.e., a region of relatively healthy tissue) at the site of the excision. In such a case, the physician must refer the patient for a further surgical procedure to remove the suspect region of tissue for a biopsy.
FIGS. 1A and 1B assist in illustrating the issues presented above. For example, FIG. 1A illustrates an endoscopic view (e.g., a view of a cavity or organ using endoscopic visualization) of the base tissue 4 within an organ 2. As shown, because the initial examinations are often performed via a minimally invasive procedure, the limited area or tortuosity within the organ 2 increases the difficulty of navigating and manipulating tools to the site for removal of tissue and/or closing of openings within the tissue 4.
FIG. 1B illustrates two different polyps 6, where the polyp 6 on the upper portion of the figure connects to the base tissue 4 via a stalk 8. The polyp 6 on the lower portion of the figure directly extends from the base tissue 4 and contains a margin 10, which represents the transition of the polyp or suspect tissue 6 to the base tissue 4. In either case, a physician will only remove the polyp if the physician can be assured of removing the entire polyp without leaving suspect tissue behind. In addition, the physician will often be hesitant to remove such a region of tissue if there is a risk that the procedure creates an opening in the wall of an organ where such an opening could lead to further complications to the patient.
There remains a need for a device, methods, and systems to allow a physician to access difficult to reach anatomic regions and to remove a region of suspect tissue in its entirety, and to provide the physician with the ability to confidently secure the tissue that remains after the excision of suspect tissue.